[ evaluation of frequency of hypotention in normal vaginal delivery with epidural anesthesia in Beheshti and Jorjani hospitals of Isfahan 2003]

ABSTRACT

Delivery pain is one of the most severe known pains that can be considered a critical experience in lifelong for every woman .Different methods has been introduced for reducing delivery pain such as non pharmacological methods [hypnotism, Acupuncture] and pharmacological methods [systemic drugs, inhalant anesthetics regional anesthesia]. Now, the most popular methods for pain relief in labor is regional anesthesia. The most common techniques are spinal, epidural, para cervical and pudendal anesthesia. The most effective ways for pain relief in labor is spinal and epidural block that Produces a complete pain relief in most women. The purpose of this study is determining the distribution of hypotention as a most common complication of epidural anesthesia in vaginal delivery that can lead to fetal distress and low APGAR score and cesarean section. This is a cross sectional [descriptive-analytic] study and 137 cases were studied. Most of them were 21-30 years old. This study was approved by the local committee of medical ethics. Gestational age was 37-42 weeks .This study was established in fall and winter of year 2003 at Beheshti and Jorjani hospitals. All of them were at the same conditions and all epidural blocks were done with the same anesthesiologist. The data analysis of all cases showed that the distribution of hypotention was 16.1%. Distribution of vertigo was 20.4% .The neonatal APGAR score of those mothers who had hypotention during delivery was [8 +/- 1.23] while APGAR score of those ones who didn't have hypotention was 9 or more [P<0.001]. Hypotension is a common side effect of epidural anesthesia and it can cause fetal distress and low APGAR score, but with infusion 500-1000 CC ringer lactate boxter before anesthesia, can reduce rate of hypotension, prevent hypoxia side effects and low score of APGAR. Of curse 1 degree reduction in APGAR score may be resulted from length of stage II of labor. So epidural anesthesia can be considered as a reliable and safe method for advertising vaginal delivery and reducing the number of unnecessary cesarean section